Robin Bekrater-Bodmann

• Professor
• Professor 'Psychobiology of chronic pain' at University Hospital RWTH Aachen

Negative cognitions related to one’s own body, here referred to as body image disturbances (BID), are common after lower limb amputation and correlate with weak psychological functioning. The Amputee Body Image Scale (ABIS) is internationally used to assess BID in persons with lower limb amputation. However, there is no psychometrically evaluated G...

Dissociation describes a state of altered consciousness in which self-related functions are no longer integrated. In its extreme form, the self is perceived as detached from the physical body, resulting in so-called out-of-body experiences (OBEs). It has been previously proposed that altered bottom-up sensory integration contributes to this kind of...

Training programs, based on principles of brain-plasticity and skill learning, are useful in counteracting functional decline in pathological conditions. Training effects of such procedures are well described but their adaptive features are usually not reported. A software framework designed for a long-term home training program is presented. It gr...

Objective Inflammatory bowel diseases (IBD) are accompanied by symptoms that can vastly affect patients’ representations of their bodies. The aim of this study was to investigate alterations in body evaluation and body ownership in IBD and their link to interoceptive sensibility, gastrointestinal-specific anxiety, and history of childhood maltreatm...

Background Sensory impairment has been related to age-associated cognitive decline. While these associations were investigated primarily in the auditory and visual domain, other senses such as touch have rarely been studied. Thus, it remains open whether these results are specific for particular sensory domains, or rather point to a fundamental rol...

Purpose: To perform a detailed psychometric Rasch analysis of the Prosthesis Embodiment Scale (PEmbS) administered in adults with lower limb amputation (LLA). Methods: A convenience sample of German-speaking adults with LLA (n = 150), recruited from German state agencies' databases, was asked to complete the PEmbS, a 10-item patient-reported sca...

p>This preprint collection concerns the proof-of-principle study of an adaptive algorithm used in a long-term sensory home training. It consists of the description of the adaptive procedure and supplementary material to characterize the algorithm. The main aim of the study was to determine whether the designed adaptive framework based on operant l...

p>This preprint collection concerns the proof-of-principle study of an adaptive algorithm used in a long-term sensory home training. It consists of the description of the adaptive procedure and supplementary material to characterize the algorithm. The main aim of the study was to determine whether the designed adaptive framework based on operant l...

Background: Prostheses are a primary rehabilitative intervention for people after lower limb amputation. To appropriately measure the effectiveness of prosthetic interventions, valid and reliable measures of prosthetic mobility are required. The Prosthetic Limb Users Survey of Mobility (PLUS-M) is a promising instrument for measuring prosthesis us...

Phantom limb pain (PLP) is a common consequence of the amputation of a limb. Persons with congenital limb absence (congenital amputees) or an acquired limb amputation at an early age seem to rarely experience PLP. However, the number of available studies and their sample sizes are low. In the present cross-sectional study, we assessed the presence...

Background Previous studies have shown dysfunctional emotion processing in patients with inflammatory bowel diseases (IBD), characterized by a hypersensitivity to negative emotions and a hyposensitivity to positive emotions. Models of emotion processing emphasize the importance of bodily sensations to the experience of emotions. Since there have be...

Prosthesis embodiment – the cognitive integration of a prosthesis into an amputees’ body representation – has been identified as important for prosthetic rehabilitation. However, the underlying cognitive mechanisms remain unclear. There is reason to assume that phantom limbs that are experienced as part of the bodily self (phantom self-consciousnes...

Background Borderline personality disorder (BPD) is characterized by altered perception of affective stimuli, including abnormal evaluation of nociceptive input. However, whether or not perceptual alterations are present for its positive counterpart, i.e. pleasant touch (PT), has not yet been examined. Methods In the present study, we applied stan...

Using the seminal rubber hand illusion and related paradigms, the last two decades unveiled the multisensory mechanisms underlying the sense of limb embodiment, that is, the cognitive integration of an artificial limb into one's body representation. Since also individuals with amputations can be induced to embody an artificial limb by multimodal se...

Meta-analytic results confirm acute pain hyposensitivity as a stable phenomenon in borderline personality disorder (BPD)-diagnosed individuals compared to healthy controls. This finding is no unexpected novelty per se, especially when considering that two thirds (that is, 18) of the 27 studies included in Fales et al. (in press) were already includ...

The experience of phantom limb pain (PLP) is a common consequence of limb amputation, resulting in severe impairments of the affected person. Previous studies have shown that several factors such as age at or site of amputation are associated with the emergence and maintenance of PLP. In this cross-sectional study we assessed the presence of severa...

Limb apparent motion perception (LAMP) refers to the illusory visual perception of a moving limb upon observing two rapidly alternating photographs depicting the same limb in two different postures. Fast stimulus onset asynchronies (SOAs) induce the more visually guided perception of physically impossible movements. Slow SOAs induce the perception...

Background: The mechanisms underlying chronic phantom limb pain (PLP) are complex and insufficiently understood. Altered sensory thresholds are often associated with chronic pain but quantitative sensory testing (QST) in PLP has so far been inconclusive due to large methodological variation between studies and small sample sizes. Methods: In thi...

Prosthesis embodiment (PEmb) – the cognitive integration of a prosthesis into an amputees’ body representation – has been identified as key feature of prosthetic rehabilitation. However, the underlying mechanisms remain unclear. There is reason to assume that phantom limbs that are experienced as part of the bodily self (phantom self-consciousness,...

Background Previous studies revealed an association between traumatic childhood experiences and emotional dysregulation in patients with borderline personality disorder (BPD). However, possible mediating pathways are still not fully understood. The aim of the present study was to investigate the potential mediating role of body connection, describi...

Limb apparent motion perception (LAMP) refers to the illusory visual perception of a moving limb upon observing two rapidly alternating photographs depicting the same limb in two different postures. Fast stimulus onset asynchronies (SOAs) induce the more visually guided perception of physically impossible movements. Slow SOAs induce the perception...

Phantom limb pain (PLP) accounts for a significant reduction in quality of life and is difficult to treat. Prosthesis use has been shown to negatively co-vary with PLP. Recent research on body perception in amputees suggest that prosthesis ownership, defined as the extent to which a prosthesis is experienced as being part of the body rather than an...

Perceptual integration of a prosthesis into an amputee's body representation, that is, prosthesis embodiment, has been proposed to be a major goal of prosthetic treatment, potentially contributing to the user's satisfaction with the device. However, insufficient knowledge about individual or prosthetic factors associated with prosthesis embodiment...

Sensory attenuation of self-touch, that is, the perceptual reduction of self-generated tactile stimuli, is considered a neurocognitive basis for self-other distinction. However, whether this effect can also be found in upper limb amputees using a prosthesis is unknown. Thirteen participants were asked to touch their foot sole with a) their intact h...

The perception of being located within one's body (i.e., bodily self-location) is an essential feature of everyday self-experience. However, by manipulating exteroceptive input, healthy participants can easily be induced to perceive themselves as being spatially dislocated from their physical bodies. It has previously been suggested that interocept...

Perceptual integration of a prosthesis into an amputee’s body representation, that is, prosthesis embodiment, has been proposed to be a major goal of prosthetic treatment, potentially contributing to the user’s satisfaction with the device. However, insufficient knowledge about individual or prosthetic factors predicting prosthesis embodiment chall...

Prostheses are used to at least partly restore the body after limb amputation. Making the user accepting the prosthetic device as part of his or her body, i.e., inducing prosthesis embodiment, has been identified as major aim of prosthetic treatment. However, up to now, there is no consensus about the psychometric nature of prosthesis embodiment in...

The phenomenon of sensory attenuation, that is, the perceptual reduction of intensity for self-generated stimuli, is considered a neurocognitive basis for self-other distinction. Corroboratory, such perceptual attenuation has been shown to be dependent on the sense of embodiment, that is, the perceptual incorporation of an object or body part into...

Phantom limb pain (PLP) has been associated with reorganization in primary somatosensory cortex (S1) and preserved S1 function. Here we examined if methodological differences in the assessment of cortical representations might explain these findings. We used functional magnetic resonance imaging during a virtual reality movement task, analogous to...

Background: Evaluation of one's own body highly depends on psychopathology. In contrast to healthy women, body evaluation is negative in women from several diagnostic groups. Particularly negative ratings have been reported in disorders related to childhood sexual abuse (CSA) including borderline personality disorder (BPD). However, it is unknown w...

Prostheses are used to at least partly restore the body after limb amputation. Making the user accepting the prosthetic device as part of his or her body, i.e., inducing prosthesis embodiment, has been identified as major aim of prosthetic treatment. However, up to now, there is no consensus about the psychometric nature of prosthesis embodiment in...

Background Stress‐related dissociation has been shown to negatively co‐vary with pain perception in current borderline personality disorder (cBPD). While remission of the disorder (rBPD) is associated with normalized pain perception, it remains unclear whether dissociation proneness is still enhanced in this group and how this feature interacts wit...

Body ownership, i.e., the certainty that own body parts belongs to oneself, is a fundamental feature of self-consciousness. Patients with borderline personality disorder (BPD) often show symptoms of dissociation, describing a state of detachment from reality including their own body. However, up to now, there is no study that a) quantifies body own...

Body Integrity Identity Disorder (BIID) is a non-psychotic condition wherein individuals desire amputation or paralysis of one or more healthy, fully-functioning limbs (predominantly the legs). Individuals with BIID have been suggested to have a mismatch between the perceived mental representation of the body and its actual physical structure, such...

Introduction Dementia (particularly Alzheimer’s disease, AD) is a major cause of impaired cognitive functions in the elderly. Amnestic mild cognitive impairment (aMCI) is a prodromal stage of AD, if substantiated by Alzheimer biomarkers. A neuroscientific model of pathological ageing emphasises the loss of brain plasticity, sensorimotor capacities...

Body Integrity Identity Disorder (BIID) is a non-psychotic condition wherein individuals desire amputation or paralysis of one or more healthy, fully-functioning limbs (predominantly the legs). Individuals with BIID have been suggested to have a mismatch between the perceived mental representation of the body and its actual physical structure, such...

Phantom limb pain (PLP) has been associated with both the reorganization of the somatotopic map in primary somatosensory cortex (S1) and preserved S1 function. Here we assessed the nature of the information (sensory, motor) that reaches S1 and methodological differences in the assessment of cortical representations that might explain these findings...

After limb amputation, most amputees suffer from phantom limb pain (PLP). The mechanisms underlying this condition are complex and insufficiently understood. Altered somatosensory sensitivity (either heightened or lowered) might contribute to PLP. Recent studies have tested this assumption but mainly focused on the residual limb. However, altered s...

Phantom limb pain (PLP) is a clinically relevant consequence of limb amputation and its treatment is still challenging. Mirror therapy, in other words, observing and engaging in the intact limb’s mirrored movements, offers a promising, mechanism-based treatment for PLP. However, intervention and patient characteristics, such as the realism of mirro...

The rubber hand illusion describes a phenomenon in which participants experience a rubber hand as being part of their body by the synchronous application of visuotactile stimulation to the real and the artificial limb. In the recently introduced robotic hand illusion (RobHI), a robotic hand is incorporated into one’s body representation due to the...

Archive containing acquired raw data (questionnaire scores and proprioceptive drift) for each experiment. (ZIP)

The feeling of embodiment, i.e., experiencing the body as belonging to oneself and being able to integrate objects into one’s bodily self-representation, is a key aspect of human self-consciousness and has been shown to importantly shape human cognition. An extension of such feelings towards robots has been argued as being crucial for assistive tec...

Phantom limb pain (PLP) is a common phenomenon occurring after the amputation of a limb and can be accompanied by serious suffering. Psychological factors have been shown to play an important role in other types of chronic pain, where they are pivotal in the acquisition and maintenance of pain symptoms. For PLP, however, the interaction between pai...

Purpose of review: We review evidence for the potential importance of interoception, i.e., the processing of signals arising from inside the body, for deficient psychosocial functioning in borderline personality disorder (BPD). Recent findings: Evidence suggests that variability in interoception interacts with higher-order psychological function...

Objectives The majority of limb amputees complain of phantom limb pain (PLP). The primary somatosensory cortex (S1) appears to play a key role in the perception of PLP. However, there is an ongoing debate whether (a) dysfunctional S1 reorganization or (b) preservation of S1 limb representation reflects the more valid correlate of PLP. Methods We t...

Amputation of a limb induces changes in the so-called body schema, which might be influenced by the use of prosthetic devices. Changes in the body representation associated with prosthesis use could be investigated using a hand mental rotation task. However, direct neurophysiologic evidence for the effect of prosthesis use on hand mental rotation i...

Objective: Mental rotation of body parts involves sequential cognitive processes, including visual processing, categorization and the mental rotation process itself. However, how these processes are affected by the amputation of a limb is still unclear. Methods: Twenty-five right upper-limb amputees and the same number of matched healthy control...

Introduction: Patients with borderline personality disorder (BPD) often report an unstable sense of self, which is further enhanced in dissociative states. As one consequence, BPD patients show a labile body percept, which might result in a higher degree of body plasticity. However, experimental data on body plasticity in BPD are not yet available....

A potential contributor to impaired motor imagery in amputees is an alteration of the body schema as a result of the presence of a phantom limb. However, the nature of the relationship between motor imagery and phantom experiences remains unknown. In this study, the influence of phantom limb perception on motor imagery was investigated using a hand...

An amputation represents an extensive impact on the integrity of one’s body, which can be at least partly compensated by prosthetic devices. Body plasticity describes the ability to perceive an artificial body part – such as a prosthesis – as belonging to oneself. The perception of a prosthesis belonging to the body might facilitate the interaction...

Unlabelled: Most, but not all, limb amputees develop phantom limb pain (PLP) or residual limb pain (RLP), and large interindividual differences in pain intensity and course are apparent. The present cross-sectional study of 122 double amputees investigated the possible role of genetic factors in PLP and RLP, assuming that strong individual predisp...

Personen mit einer Amputation erleben eine weitreichende Veränderung ihrer Körperintegrität, die sich auch in der neuronalen Repräsentation des Körpers im Gehirn abbildet. Eine Mehrzahl der Amputierten leidet darüber hinaus unter Phantomschmerzen, die mit Veränderungen im zentralen Nervensystem korreliert sind. Die Wiederherstellung der Körperinteg...

Borderline personality disorder (BPD) is characterized by sensory deficits such as reduced to pain perception. However, it is unknown whether these alterations, which occur primarily in emotionally stressful conditions, occur only in the somatosensory or also in other sensory modalities. This study aimed to assess whether BPD patients show alterati...

Background Mirror therapy reduces chronic pain and might also be suitable for the treatment of inflammatory rheumatic pain. Objectives On the basis of the relevant literature this article a) characterizes the universal alterations in body perception and body representation in chronic pain, b) describes the potential mechanisms underlying mirror the...

Amputation of the dominant hand forces patients to use their non-dominant hand exclusively. Whether this chronic forced use of the non-dominant hand would affect the handedness preference remains an open question. In this study, the handedness preference in amputees was evaluated using a hand laterality judgment task by comparing recognition speeds...

It is well documented that borderline personality disorder (BPD) is characterized by reduced pain sensitivity, which might be related to non-suicidal self-injury and dissociative experiences in BPD patients. However, it remains an open question whether this insensitivity relies at least partly on altered sensory integration or on an altered evaluat...

Talk

Since its original proposal, mirror therapy has been established as a successful neurorehabilitative intervention in several neurological disorders to recover motor function or to relieve pain. Mirror therapy seems to operate by reactivating the contralesional representation of the non-mirrored limb in primary motor- and somatosensory cortex. Howev...

The experience of post-amputation pain such as phantom limb pain (PLP) and residual limb pain (RLP), is a common consequence of limb amputation, and its presence has negative effects on a person's well-being. The continuity hypothesis of dreams suggests that the presence of such aversive experiences in the waking state should be reflected in dream...

Phantom pain is a frequent sequel of the amputation of a limb or another body part and must be differentiated from residual limb pain, postoperative pain, and other chronic pain problems such as back pain that may occur simultaneously. In this chapter, we first discuss how maladaptive plasticity of the central nervous system in interaction with per...

The perception of one’s own body requires the involvement of several sensory modalities. The integration of somatosensory and visual input is considered to be the prerequisite for higher-order body experience such as ownership and agency, ultimately accompanied by a sense of self. The sense of self has been shown to be altered in chronic pain patie...

Extended viewing of movements of one’s intact limb in a mirror as well as motor imagery have been shown to decrease pain in persons with phantom limb pain or complex regional pain syndrome and to increase the movement ability in hemiparesis following stroke. In addition, mirrored movements differentially activate sensorimotor cortex in amputees wit...

Phantom limb pain (PLP) is a common consequence of amputation and is difficult to treat. Mirror therapy (MT), a procedure utilizing the visual recreation of movement of a lost limb by moving the intact limb in front of a mirror, has been shown to be effective in reducing PLP. However, the neural correlates of this effect are not known. We investiga...

No abstract available

In the so-called rubber hand illusion, synchronous visuotactile stimulation of a visible rubber hand together with one's own hidden hand elicits ownership experiences for the artificial limb. Recently, advanced virtual reality setups were developed to induce a virtual hand illusion (VHI). Here, we present functional imaging data from a sample of 25...

Mirror training and movement imagery have been demonstrated to be effective in treating several clinical conditions, such as phantom limb pain, stroke-induced hemiparesis, and complex regional pain syndrome. This article presents an augmented reality home-training system based on the mirror and imagery treatment approaches for hand training. A head...

Background / Purpose: Mirror therapy has been proven to be effective in treating several chronic pain conditions like phantom limb pain after amputation (1) or complex regional pain syndrome (2). But, classical mirror boxes have some limitations in everyday therapy and research, like their limited size and weight.The present study evaluated the uti...

Objectives: Several studies have shown that mirrored arm or leg movements can induce altered body sensations. This includes the alleviation of chronic pain using congruent mirror feedback and the induction of abnormal sensation in healthy participants using incongruent mirror feedback. Prior research has identified neuronal and conceptual mechanism...

In this paper, we introduce a virtual reality based setup for triggering and studying illusory sensations of limb ownership as known from the popular rubber hand illusion. Unlike a similar setup introduced recently, this experiment is triggered by software automatically, which provides for a good synchrony and for high accuracy of visuotactile stim...

The rubber hand illusion (RHI) offers the opportunity to systematically manipulate the experience of embodiment, which is here used to describe the subjective integration of an external object into one's body representation. Among the cortical regions involved in the processing of body perception, the ventral premotor cortex seems to be crucial in...

Phantom sensations, that is, sensations perceived in a body part that has been lost, are a common consequence of accidental or clinical extremity amputations. Most amputation patients report a continuing presence of the limb, with some describing additional sensations such as numbness, tickling, or cramping of the phantom limb. The type, frequency,...

Abstracts of Pain in Europe VII, 7th Congress of the European Federation of Pain Chapers (EFIC)

Background: Phantom limb pain (PLP) is a common consequence of amputation and is difficult to treat. Mirror therapy (MT), a procedure utilizing the visual recreation of movement of a lost limb by moving the intact limb in front of a mirror, has been shown to be effective in reducing PLP. However, the neural correlates of this effect are not known....

The perception of one's own hand is an eminently coherent impression: proprioceptive, tactile, and visual inputs usually correspond perfectly. Current theoretical frameworks postulate that this multimodal integration is required for a feeling of ownership of the body, and is ultimately accompanied

SUMMARY Apart from their contribution to the overall knowledge of perception and related processes, sensory illusions have been used in recent years to treat and better understand pain disorders such as phantom limb pain or complex regional pain syndrome. With the help of modern imaging techniques, we can examine connections between basic processes...